The challenging economics of the health care industry dealt a painful blow to Hawaii in the past week, with the announcement that bankruptcy would shutter Hawaii Medical Centers’ two hospitals, fulfilling separate but equally crucial functions.

HMC West has been critical to the acute-care and emergency medical needs of the growing Leeward Coast and Ewa populations, while its sister institution, HMC East, has been home to Hawaii’s only organ transplant center.

Oahu health care providers and officials, and more than 900 suddenly jobless employees, must grapple with a difficult transition, made even more distressing for coinciding with the holiday season.

That’s something the state must work to remedy, by providing prompt guidance through the unemployment maze as well as oversight, ensuring that the medical-services network can carry on with as little disruption as possible.

In the face of such grim news, it was heartening to see The Queen’s Medical Center step into the breach and pledge to replace the Transplant Institute of the Pacific, an invaluable resource for 42 years on the HMC East campus in Liliha.

Transplant programs are not profit centers, and the staffing and construction costs to accommodate a program at Queen’s has been estimated at up to $8 million over five years.

So this gesture clearly was intended as fulfilling a community commitment. Queen’s promises in its mission statement "to provide in perpetuity quality health care services." For the 400-plus Hawaii residents waiting for an organ transplant, the lack of these services certainly will diminish their well being.

There is a long road ahead. What Queen’s executives announced Tuesday was simply initiation of the first steps to begin a new organ transplantation program: seeking three separate approvals.

One application is for clearance by the United Network for Organ Sharing, the national credentialing organization that ensures high standards. Another is to the federal Centers for Medicare & Medicaid Services, while at the local level, the State Health Planning & Development Agency must issue a certificate of need.

Two of the physicians heading the medical team, Drs. Whitney Limm and Linda Wong, expressed their hope that permits can be expedited so that services can resume in two months. That is lightning speed by state standards; Department of Health officials, who already have indicated plans to streamline the certificate of need review, should work to meet that high bar.

The reason: The longer that transplant services are on hiatus, the likelier it is that the care for Hawaii transplants, and the lives of their families, will be disrupted.

"We’re 2,500 miles from the next transplant center," Wong told the Star-Advertiser in a recent interview. "Even if you wait in Hawaii, when they call you, you have to fly there quickly in order to get your transplant. And if you’re a liver patient, you’re probably too sick to get on the plane at the moment you need the liver. So that’s why you probably have to relocate and live there."

All of that adds costs and upheaval to households, many of which already are under considerable financial stress.

As far as federal reviews are concerned, the doctors are hopeful that speedy approvals are possible, citing precedent in the quick turnaround to reestablish hospital care in the wake of Hurricane Katrina. But while what happened to HMC seems disastrous in the islands, it’s not a typical federal emergency. Hawaii’s congressional delegation must step up to grease the wheels of government.

Here at home, lawmakers and the Abercrombie administration will have their hands full, seeing where the state might reinforce the health network; the possibility of financial aid for the startup should be explored.

Overall, this crisis presents the state with a test of its capacity to solve problems. The stakes could not be higher. Hawaii needs to ace this test.